Digital Health Archives - Cardionerds

Digital Health Archives - Cardionerds

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Digital Health Archives - Cardionerds episodes

  • 366. Digital Health: Integrating Digital Health into Practice with Dr. Alexis Beatty and Dr. Seth Martin

    CardioNerds (Dr. Dan Ambinder), Dr. Nino Isakadze (EP Fellow at Johns Hopkins Hospital), and Dr. Karan Desai (Cardiology Faculty at Johns Hopkins Hospital) join Digital Health Experts, Dr. Alexis Beatty (Cardiologist and associate professor in the department of epidemiology and biostatistics at UCSF) and Dr. Seth Martin (Director of the Johns Hopkins Center for Mobile Technologies to Achieve Equity in Cardiovascular Health (mTECH), which is part of the American Heart Association (AHA) Strategically Focused Research Networks on Health Technology & Innovation) for another installment of the Digital Health Series. In this specific episode, we discuss pearls, pitfalls, and everything in between for emerging digital health innovators. This series is supported by an ACC Chapter Grant in collaboration with Corrie Health.  Audio editing by CardioNerds Academy Intern, student doctor Shivani Reddy.

    In this series, supported by an ACC Chapter Grant and in collaboration with Corrie Health, we hope to provide all CardioNerds out there a primer on the role of digital heath in cardiovascular medicine. Use of versatile hardware and software devices is skyrocketing in everyday life. This provides unique platforms to support healthcare management outside the walls of the hospital for patients with or at risk for cardiovascular disease. In addition, evolution of artificial intelligence, machine learning, and telemedicine is augmenting clinical decision making at a new level fueling a revolution in cardiovascular disease care delivery. Digital health has the potential to bridge the gap in healthcare access, lower costs of healthcare and promote equitable delivery of evidence-based care to patients.

    This CardioNerds Digital Health series is made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Nino Isakadze and Dr. Karan Desai.  

    Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.

    CardioNerds Digital Health Series Page
    CardioNerds Episode Page
    CardioNerds Academy
    Cardionerds Healy Honor Roll

    CardioNerds Journal Club
    Subscribe to The Heartbeat Newsletter!
    Check out CardioNerds SWAG!
    Become a CardioNerds Patron!

    45 min
  • 338. Digital Health: Tips for the Digital Health Innovator with Dr. David Cho and Dr. Francoise Marvel

    Join CardioNerds Co-Founder Dr. Dan Ambinder, Dr. Nino Isakadze (EP Fellow at Johns Hopkins Hospital), Dr. Karan Desai (Cardiology Faculty at Johns Hopkins Hospital and Johns Hopkins Bayview) join Digital Health Experts, Dr. Francoise Marvel (Co-Founder of Corrie Health and Co-Director of Johns Hopkins Digital Health Lab) and Dr. David Cho (Chair of the ACC Health Care Innovation Council) for another installment of the Digital Health Series. In this specific episode, we discuss pearls, pitfalls and everything in between for the emerging digital health innovator. This series is supported by an ACC Chapter Grant in collaboration with Corrie Health. Notes were drafted by Dr. Karan Desai. Audio editing was performed by student Dr. Shivani Reddy.

    In this series, supported by an ACC Chapter Grant and in collaboration with Corrie Health, we hope to provide all CardioNerds out there a primer on the role of digital heath in cardiovascular medicine. Use of versatile hardware and software devices is skyrocketing in everyday life. This provides unique platforms to support healthcare management outside the walls of the hospital for patients with or at risk for cardiovascular disease. In addition, evolution of artificial intelligence, machine learning, and telemedicine is augmenting clinical decision making at a new level fueling a revolution in cardiovascular disease care delivery. Digital health has the potential to bridge the gap in healthcare access, lower costs of healthcare and promote equitable delivery of evidence-based care to patients.

    This CardioNerds Digital Health series is made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Nino Isakadze and Dr. Karan Desai.  

    Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.

    CardioNerds Digital Health Series Page
    CardioNerds Episode Page
    CardioNerds Academy
    Cardionerds Healy Honor Roll

    CardioNerds Journal Club
    Subscribe to The Heartbeat Newsletter!
    Check out CardioNerds SWAG!
    Become a CardioNerds Patron!

    Pearls and Quotes – Tips for the Digital Health Innovator
    1. A critical first step in developing a digital health intervention is defining the clinical problem rather than developing the technology itself.
    2. Most digital transformations – whether in medicine or other industries – require several iterations for the technology to develop and demonstrate value. A key aspect of this iterative process was human-centered design: involving patients, their families, and other end-users early in the development of the digital health intervention.
    3. Dr. Marvel and colleagues have developed a 6-step process for innovators to consider in taking a concept to product.
      4. Notes – Tips for the Digital Health Innovator
      1. In this episode, we discussed with Dr. Marvel and Dr. Cho some general concepts on how to develop digital health interventions (DHI). DHIs have a broad definition, including any software or hardware application used to improve access, quality, efficacy or efficiency and they exist in various modalities (e.g., text message, mobile apps, wearables).
      2. Dr. Marvel has previously authored a roadmap for digital health intervention that provides guidance for an interdisciplinary approach to developing effective and evidence-based DHIs. As discussed on the episode, a critical first step is defining the clinical problem an innovator is attempting to solve instead of attempting to develop the technology solution first and then adapting it to the problem.
      3. Drs. Marvel and Cho emphasized that most digital transformations – whether in medicine or other industry – require several iterations for the technology to develop and demonstrate value. Frequent assessment in a structured manner will help the intervention mature over time. Dr. Marvel noted that a key aspect of this iterative process was human-centered design: involving patients, their families, and other end-users early in the development of the DHI.
      4. For instance, with Corrie Health, Dr. Marvel noted that patients who had suffered acute myocardial infarction were involved in a Patient Advisory Board, demonstrations were held for the Patient Advisory board, and patients invited to participate on the research team.
      5. Our experts also noted there is a wealth of literature on the common barriers in DHI adoption, including regulatory and cost requirements. Data security and interoperability are other major concerns for digital health innovators. An understanding of the healthcare ecosystem can help innovators recognize these barriers early in the design process.
      6. In the aforementioned article, Dr. Marvel and colleagues define a stepwise process to help innovators bring their concept to product:
        • Early multidisciplinary accelerators compromised of a variety of stakeholders
        • Establishment of institutional navigators who can provide a pathway through institutional roadblocks and operational factors
        • Encouraging mentorship and championship from faculty-level and administration
        • Devotion of administrative/business/finance leadership to create sustainable business models to address the reimbursement and policy landscapes
        • Creation of expedited IRB pathways for low-risk DHIs
        • The design of systematic processes to access patient evaluations of new technologies and consumer-centered design.
          • References – Tips for the Digital Health Innovator
          1. Marvel FA, Wang J, Martin SS. Digital Health Innovation: A Toolkit to Navigate From Concept to Clinical Testing. JMIR Cardio. 2018 Jan 18;2(1):e2. doi: 10.2196/cardio.7586
          2. Glaser J and Shaw S. Digital Transformation Success: What Can Health Care Providers Learn from Other Industries. NEJM Catalyst. 2022 Mar 22. doi: 10.1056/CAT.21.0434
            3. 48 min
          3. 332. Digital Health: Digital Health and Health Equity with Dr. LaPrincess Brewer

            Join CardioNerds Co-Founder Dr. Dan Ambinder, Dr. Nino Isakadze (EP Fellow at Johns Hopkins Hospital), Dr. Karan Desai (Cardiology Faculty at Johns Hopkins Hospital and Johns Hopkins Bayview) join Digital Health Expert, Dr. La Princess Brewer (Associate Professor of Medicine Mayo Clinic Rochester) for another installment of the Digital Health Series. In this specific episode, we discuss how digital health can both reduce and amplify health disparities. This series is supported by an ACC Chapter Grant in collaboration with Corrie Health.  Notes were drafted by Dr. Karan Desai. Audio editing was performed by student Dr. Shivani Reddy.

            In this series, supported by an ACC Chapter Grant and in collaboration with Corrie Health, we hope to provide all CardioNerds out there a primer on the role of digital heath in cardiovascular medicine. Use of versatile hardware and software devices is skyrocketing in everyday life. This provides unique platforms to support healthcare management outside the walls of the hospital for patients with or at risk for cardiovascular disease. In addition, evolution of artificial intelligence, machine learning, and telemedicine is augmenting clinical decision making at a new level fueling a revolution in cardiovascular disease care delivery. Digital health has the potential to bridge the gap in healthcare access, lower costs of healthcare and promote equitable delivery of evidence-based care to patients.

            This CardioNerds Digital Health series is made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Nino Isakadze and Dr. Karan Desai.  

            Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.

            CardioNerds Digital Health Series Page
            CardioNerds Episode Page
            CardioNerds Academy
            Cardionerds Healy Honor Roll

            CardioNerds Journal Club
            Subscribe to The Heartbeat Newsletter!
            Check out CardioNerds SWAG!
            Become a CardioNerds Patron!

            Pearls and Quotes
            1. Digital redlining occurs when a particular group has limited access to key services based on race and ethnicity, perpetuating inequities. Throughout this podcast episode, Dr. Brewer emphasizes how community engagement early in the creation of digital health technologies can mitigate structural inequities. 
            2. Dr. Brewer spoke about methods to develop innovative digital health tools that are culturally sensitive and inclusive, specifically community-based participatory research (CBPR). In CBPR, community members are partners with researchers in each step of the intervention.
            3. While certain individuals and communities may have physical access to digital health tools, they still may remain inaccessible for several reasons.
              4. Notes
              1. In this episode, we focus on achieving digital health equity and how the very technologies meant to reduce health disparities can widen them. We started by discussing a paper from Dr. Brewer and colleagues that crystallized how digital health disparities can occur with the example of Pokémon Go. As described in this paper, this mobile application was one of the most used applications worldwide. It incentivized users to collect virtual goods at various physical locations termed PokéStops. For public health professionals, this mobile app represented an engaging way to promote physical activity amongst users. However, some racial and ethnic minority groups in low-income, urban areas quickly took notice of the lack of PokéStops within their neighborhoods. As researchers noted, this could be considered examples of digital redlining, or limiting a particular group from key services based on race and ethnicity. As Dr. Brewer notes in the paper, the Pokémon Go developers relied on maps that were crowdsourced from a majority white male demographic. While it may not have been deliberate, the development process created a structural digital inequity placing certain communities at a home-court disadvantage. Throughout this podcast episode, Dr. Brewer emphasizes how community engagement early in the creation of digital health technologies can mitigate structural inequities. 
              2. Dr. Brewer spoke about methods to develop innovative digital health tools that are culturally sensitive and inclusive, specifically community-based participatory research (CBPR). In CBPR, community members are equal partners with researchers and included at every phase of the project (or development of a digital health tool. Learn more about CBPR from Dr. Brewer and her FAITH! application by listening to our Narratives in Cardiology Series with Episode #131. As demonstrated by in Dr. Brewer’s own research and digital health tool creation, early and consistent community involvement led to high recruitment and retention rates of study participants (100% and 98%, respectively).
              3. We also discussed that one of the misunderstood aspects of the discussion around digital health equity is the concept of access. Access can mean many different things including broadband internet infrastructure or internet-enabled devices. But even if the infrastructure is available – as Dr. Brewer has noted in her research for instance, African Americans have similar smartphone ownership to the general populations – digital health tools may be inaccessible because digital health interventions are not tailored to specific populations
                4. References
                1. Brewer LC, Fortuna KL, Jones C, Walker R, Hayes SN, Patten CA, Cooper LA. Back to the Future: Achieving Health Equity Through Health Informatics and Digital Health. JMIR Mhealth Uhealth. 2020 Jan 14;8(1):e14512.
                2. Brewer LC, Hayes SN, Jenkins SM, Lackore KA, Breitkopf CR, Cooper LA, Patten CA. Improving cardiovascular health among African-Americans through mobile health: the FAITH! app pilot study. J Gen Intern Med. 2019 Aug;34(8):1376–8.
                3. Brewer LC, Jenkins S, Lackore K, Johnson J, Jones C, Cooper LA, Breitkopf CR, Hayes SN, Patten C. mHealth intervention promoting cardiovascular health among African-Americans: recruitment and baseline characteristics of a pilot study. JMIR Res Protoc. 2018 Jan 31;7(1):e31.
                4. Israel BA, Schulz AJ, Parker EA, Becker AB. Review of community-based research: Assessing partnership approaches to improve public health. Annu Rev Public Health. 1998;19:173–202.
                5. Weinstein JN, Geller A, Negussie Y, Baciu A. Communities in Action: Pathways to Health Equity. Washington, DC: National Academies Press; 2017.
                  6. 35 min
                6. 273. Digital Health: The Digital Transformation of Cardiovascular Medicine with Dr. Dipti Itchhaporia

                  Join CardioNerds Co-Founder Dr. Dan Ambinder, Dr. Nino Isakadze (EP Fellow at Johns Hopkins Hospital), Dr. Karan Desai (Cardiology Faculty at Johns Hopkins Hospital and Johns Hopkins Bayview) and student Dr. Shivani Reddy (Medical Student at Western Michigan University Homer Stryker SOM), as they discuss how digital health in changing the landscape of CV Disease Management with Dr. Dipti Itchhaporia (Past President of the ACC). The overall goal of this episode is to broadly describe the current landscape of digital health for cardiovascular disease, define “digital health tools” and describe their role in cardiovascular disease management. Episode audio was edited by student Dr. Shivani Reddy and show notes were developed by Dr. Nino Isakadze.

                  In this series, supported by an ACC Chapter Grant and in collaboration with Corrie Health, we hope to provide all CardioNerds out there a primer on the role of digital heath in cardiovascular medicine. Use of versatile hardware and software devices is skyrocketing in everyday life. This provides unique platforms to support healthcare management outside the walls of the hospital for patients with or at risk for cardiovascular disease. In addition, evolution of artificial intelligence, machine learning, and telemedicine is augmenting clinical decision making at a new level fueling a revolution in cardiovascular disease care delivery. Digital health has the potential to bridge the gap in healthcare access, lower costs of healthcare and promote equitable delivery of evidence-based care to patients.

                  This CardioNerds Digital Health series is made possible by contributions of stellar fellow leads and expert faculty from several programs, led by series co-chairs, Dr. Nino Isakadze and Dr. Karan Desai.  

                  Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.

                  CardioNerds Digital Health Series Page
                  CardioNerds Episode Page
                  CardioNerds Academy
                  Cardionerds Healy Honor Roll

                  CardioNerds Journal Club
                  Subscribe to The Heartbeat Newsletter!
                  Check out CardioNerds SWAG!
                  Become a CardioNerds Patron!

                  Pearls and Quotes
                  1. COVID 19 pandemic accelerated the digital transformation of healthcare.
                  2. Digital health tools exist for disease prediction, diagnosis and management.
                  3. Digital health can increase access to care and lower overall cost expenditure.
                  4. Clinicians, policy makers, and insurance providers should be involved to facilitate rapid and effective adoption of digital health interventions to better patient and population health.
                    5. Notes

                    1. How did the COVID-19 pandemic accelerate the process of adopting digital health tools in healthcare including cardiovascular disease management?

                    • Although technological advances and technological transformation have been implemented in many aspects of our lives, their adoption in healthcare, including cardiovascular disease management has lagged behind.
                    • The COVID-19 pandemic was a force that led to the Tech-celeration as we adopted telemedicine and remote patient monitoring platforms in a short time to preserve access to healthcare.
                    • Technology became essential not to replace but to support face to face interactions.
                    • Reimbursement models were rapidly created that fit digital healthcare delivery; however it remains unclear whether these models will continue to be in effect in the post pandemic era.

                      • 2.  Can you discuss broadly the current landscape of evidence-based digital health tools available for cardiovascular disease management?

                      • Three components of digital health landscape can be broken down as follows:
                        • Virtual care/telehealth platforms
                        • Remote patient monitoring systems including implanted devices, patches, wearables, smartphone applications and more
                        • Artificial intelligence to allow meaningful use of the big data obtained from remote patient monitoring systems in therapeutic and disease management pathways

                          •    3. How can we balance benefits and burden of digital health tools? 

                          • The pure definition of digital transformation is using digital tools to make lives of patients and clinicians better.
                          • The data we derive from digital health technologies is only useful insofar that it can be used to affect change. We need analytical tools like AI to create actionable information and summary sheets to summarize data in meaningful ways.
                          • While developing digital health tools, companies should engage in co-designing processes with end users. In the case, clinicians should receive iterative feedback so that tools that are developed meet user needs.

                            •    4. What are the ways to ensure inclusiveness in design and delivery of digital health tools for disease management to every patient, including those from underrepresented racial and ethnic groups?

                            • We need to improve access to infrastructure needed to operate digital health tools. This requires engagement with institutions, organizations and legislators.
                            • Digital health tools need to be co-designed with a diverse set of users including those with low tech literacy as well as multiple stakeholders.
                            • We need to communicate with community members when translating science to make sure that the process is transparent to address any trust issues or skepticism.

                              • 5. How do we ensure data privacy, especially when health data is stored on different servers? 

                              • There are gaps in federal legislation that need to be addressed.
                              • IT health standards for handling data collected outside hospital settings with digital health tools should be developed in an iterative manner. When health IT standards are developed, we need to enforce them and ensure that they are working well with feedback systems.
                              • Individuals need to control how their data is health systems and other entities use and store their data.
                              • Clinicians need to trust that data is stored in a secure manner when appropriate channels are utilized.
                              • Data management should be a transparent process.
                              • Confidentiality is going to be fundamental and all entities involved should be subject to HIPPA rules.

                                • 6. How can big organizations help advocate for updated reimbursement models and policy changes to allow for greater adoption of digital health tools?

                                • Big professional organizations have pivotal roles in promoting the digital transformation, and implementing digital re-design.
                                • Big professional organizations can act as conduits between different stakeholders, promote digital literacy in public as well as among professionals.
                                • They can create standards and guidelines on proper use of digital health technology, facilitate robust studies to test clinical impact, and advocate for reimbursement and policy changes.

                                  •  7. What are the near future and long-term opportunities of digital health tools in cardiovascular disease management?

                                  • Digital transformation is in progress, and we need clinicians to be at the center of innovation to drive development of care pathways and care delivery models.
                                  • Digital solutions should promote health equity, add value to healthcare systems, and promote wellbeing of clinicians
                                    • References
                                    1. Bayoumy K, Gaber M, Elshafeey A, et al. Smart wearable devices in cardiovascular care: where we are and how to move forward. Nat Rev Cardiol. 2021 Aug;18(8):581-599. doi: 10.1038/s41569-021-00522-7. Epub 2021 Mar 4. PMID: 33664502.
                                    2. Cowie MR, Lam CSP. Remote monitoring and digital health tools in CVD management. Nat Rev Cardiol. 2021 Jul;18(7):457-458. doi: 10.1038/s41569-021-00548-x. PMID: 33824486; PMCID: PMC8023506.
                                    3. Itchhaporia D. Navigating the Path to Digital Transformation. J Am Coll Cardiol. 2021 Jul 27;78(4):412-414. doi: 10.1016/j.jacc.2021.06.018. PMID: 34294274.
                                      4. 30 min

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                                    A cardiology platform that aims to democratized cardiovascular education